“She’s dead.”
“What?”
“They drove up, threw her out of the car, and left,” the nurse said.
I was standing by triage as a flurry of panicked bodies rushed by me.
Not more than 10 seconds later did I see something I’ll never forget.
That same set of panicked humans were pushing a lifeless body that lay in a crumpled heap on a wheelchair.
“Trauma 1!” I heard them yell “Let's go! Let's go!”
I stood. Frozen. Trying to process all that was going on.
Then I felt a large palm on the upper part of my back.
“Come on, kid. It’s your time to shine”.
I followed the hand of that nurse into the trauma room. It seemed like there were 100 people there. As if watching a chaotic ballet, they moved around with disordered yet purposeful movements, following the tune of their training.
I found myself in line. Quiet, totally in my head, and panicking. I could feel the perspiration seeping from my armpits.
“Ahh. Ahh. Ahh. Ahh. Staying alive. Staying alive…”
That’s all I could think about. That’s all I needed to think about.
“Switch compressors on my count!”
“Staying alive…Staying alive….”
“3…2…1…”
And then the chorus ended.
I stood over a lifeless body. Hands clasped, moving my arms to the rhythm of that song which seemed so ironic right now. My training kicked in as I simultaneously felt like I was having an out of body experience.
I overheard amongst the chaos that she was 16 years old.
Wow.
I didn’t have time to think about that. Right now I was the main driver of pumping blood to her lifeless body.
“Good compressions!”
The sweat underneath my armpits got heavier. More started to form on my brow. Each time I pressed on her chest, I felt her sternum collapse, and her ribs start to break.
“Please wake up” I begged her silently. “Please”.
“Switch in….3…2…1….Go!”
I was pulled off the chest. I wiped the sweat from my brow.
As I turned away I ran right into my attending. In his hand was a small drill, about the size of his palm.
“Here. Take this. Let’s go.”
Ducking and diving between people in the room. We made our way to the leg.
“Please wake up” I begged her silently. “Please”.
“Here”. He said. “Go all the way in.”
I put the drill to her leg. Pressed the trigger. And into her bone went the intraosseous line for IV access.
I got back in line for more compressions.
But I never went again.
The code was called after 30 minutes. There was a moment of silence as we all collectively mourned the loss of this young, beautiful 16 year old girl.
But the moment was brief and fleeting.
There were other patients waiting to be seen.
As I walked out of the room, I felt the urge to look back one more time.
A profound sense of grief and despair washed over me as I watched the sheet being draped over her face.
I pulled the curtain from the trauma bay back to the main corridor. At that moment all I wanted was nothing more than to run into a dark room, curl up into a ball and cry.
Insead my attending met me, face to face, chart in hand.
“Room 32. 12 year old, rule out appendicitis. Go see them, please.”
I walked into that next room to see the next patient, wondering if they too were on the verge of death.
Please, no. I couldn't handle that right now.
And fortunately, they weren’t. I began the interview as I had been trained. And as I gathered the information from this 12 year old and his mom at the bedside, I wondered if they somehow knew that just 10 minutes ago, I hovered over a lifeless body, staring death in the face.
I finished my shift that night and walked out. I felt numb. I felt cold. There was no debrief for what had just happened. It was time to go home, try and sleep, and come back and return to work tomorrow, continuing on as if nothing happened.
If you are in medicine, or healthcare in general, you have had a similar story. I don't recount this tale in order to display that I am unique, because I assuredly I am not. Part of our job and training is dealing with death day in and day out. It also carrying around extremely heavy emotional burdens from very sick patients, who are suffering from crippling diseases.
After that night in the ER, I wondered if I could continue on at that clip.
I’m writing today telling you I somehow managed to do just that.
I became extremely proficient at “shelving” my feelings around death and suffering. That is what we are trained to do. As time went on, having patients dying in front of me, or hearing about how sick they were, burdened me less. I was able to move from room to room, less encumbered by what I had just dealt with moments before. At the end of the day, I would go home and live my life, hardly ever thinking about the gravity of situations I dealt with that day.
I became desensitized. I became numb. I became cold.
Essentially, I became a robot.
People would ask me, “how do you do it?”.
“I just do”. I said. “That’s my job”.
But I don’t know if that was a truthful response. I think whether or not we like to admit it, under the surface the emotional toll of this job wears on us. It slowly erodes at us, chipping away at the layers of our soul. It is not natural to be able to watch a human die in one room, then proceed to the next room like nothing happened. And over time it manifests as cynicism, apathy, depression, anxiety, resentment and burnout. These are extremely heavy feelings that are never dealt with. We are asked to pick up and move on despite encountering some of the most intense experiences that people will ever see.
“I just do”. I said. “That’s my job”.
We have to acknowledge this. We have to do a better job of normalizing that the intensity of the work we do affects us both consciously and subconsciously. We have to be willing to check in with each other, daily. We have to try and do a better job of debriefing after these traumatic situations. We have to remember we are humans and we have a limit. We must not push past that, lest we be too far gone.
And that is what is important about community. Share with me here. Reach out to me directly. Reach out to peers. That is also why there are communities like the one I just joined, Physicians Anonymous, to help you with these things. To help you with all things. Because let me be frank with you: Our job is extremely difficult. It is heavy. It is burdensome, both on the job and when we leave. It hovers over you, dripping drops of emotional pain, whether you’re aware of it or not. I am trying to do my part to be more cognizant - more human. It is tough to regain that part of me. But I am trying.
Let’s be more proactive about our trauma. Let’s engage with others. Let’s be vulnerable and honest so we can be the best version of ourselves for patients and loved ones. It takes a village - I promise you, you can’t do it alone. Heroes need help, too.
RESOURCE OF THE WEEK:
As hyperlinked above (and again HERE) Physicians Anonymous is an excellent resource for any physician who is struggling.
You will find a wealth of FREE resources to support you (coaching, meetings, articles) in whatever capacity you need.
I am looking to get more involved myself.
Please take a look!
SOCIAL MEDIA
-We are still trying to grow! Follow us on Instagram: DrBryceBowers and on my LinkedIn
3 ACTION ITEMS FOR YOU TO DO THIS WEEK:
Think about a traumatic event you’ve seen or experienced. Ask yourself - have I debriefed from this, or is it still playing an active role in how I function?
Identify 3 friends, family or resources you can utilize to help you process a difficult time you’ve had in your life.
We all have experienced traumatic situations in life. Journal on 3 positive ways you’ve coped, and 3 negative ways. What can you do to turn those negative mechnaisms into positive ones?
Beautiful As Always & YES ☀️ bringing your story to LIGHT reveals the truth we all need to hear 🌎 thank you for doing the work & raising us all along the way ❤️🎄✨🙏☀️🌊🌎🌾💫
Just doing the work that I feel drawn to do! Love you, Annie!